Adrenal, Thyroid, Parathyroid Exam Questions and
answers
A client with a diagnosis of addisonian crisis is being admitted to the intensive care unit. Which findings
will the interprofessional health care team focus on? Select all that apply.
1. Hypotension
2. Leukocytosis
3. Hyperkalemia
4. Hypercalcemia
5. Hypernatremia - ✅✅Hypotension
Hyperkalemia
In Addison's disease, also known as adrenal insufficiency, destruction of the adrenal gland leads to
decreased production of adrenocortical hormones, including the glucocorticoid cortisol and the
mineralocorticoid aldosterone. Addisonian crisis, also known as acute adrenal insufficiency, occurs when
there is extreme physical or emotional stress and lack of sufficient adrenocortical hormones to manage
the stressor. Addisonian crisis is a life-threatening emergency. One of the roles of endogenous cortisol is
to enhance vascular tone and vascular response to the catecholamines epinephrine and norepinephrine.
Hypotension occurs when vascular tone is decreased and blood vessels cannot respond to epinephrine
and norepinephrine. The role of aldosterone in the body is to support the blood pressure by holding salt
and water and excreting potassium. When there is insufficient aldosterone, salt and water are lost and
potassium builds up; this leads to hypotension from decreased vascular volume, hyponatremia, and
hyperkalemia. The remaining options are not associated with addisonian crisis.
The nurse is reviewing the laboratory test results for a client with a diagnosis of Cushing's syndrome.
Which laboratory finding would the nurse expect to note in this client?
1.A platelet count of 200,000 mm3 (200 × 109/L)
2.A blood glucose level of 110 mg/dL (6.28 mmol/L)
3.A potassium (K+) level of 5.5 mEq/L (5.5 mmol/L)
4.A white blood cell (WBC) count of 6000 mm3 (6 × 109/L) - ✅✅A potassium (K+) level of 5.5 mEq/L
(5.5 mmol/L)
,The client with Cushing's syndrome experiences hyperkalemia, hyperglycemia, an elevated WBC count,
and elevated plasma cortisol and adrenocorticotropic hormone levels. These abnormalities are caused
by the effects of excess glucocorticoids and mineralocorticoids in the body. The laboratory values listed
in the remaining options would not be noted in the client with Cushing's syndrome.
The nurse is caring for a client with a diagnosis of Addison's disease and is monitoring the client for signs
of Addisonian crisis. The nurse should assess the client for which manifestation that would be associated
with this crisis?
1.Agitation
2.Diaphoresis
3.Restlessness
4.Severe abdominal pain - ✅✅Severe abdominal pain
Addisonian crisis is a serious life-threatening response to acute adrenal insufficiency that most
commonly is precipitated by a major stressor. The client in addisonian crisis may demonstrate any of the
signs and symptoms of Addison's disease, but the primary problems are sudden profound weakness;
severe abdominal, back, and leg pain; hyperpyrexia followed by hypothermia; peripheral vascular
collapse; coma; and renal failure. The remaining options do not identify clinical manifestations
associated with addisonian crisis.
The nurse is performing an assessment on a client with a diagnosis of Cushing's syndrome. Which should
the nurse expect to note on assessment of the client?
1.Skin atrophy
2.The presence of sunken eyes
3.Drooping on 1 side of the face
4.A rounded "moonlike" appearance to the face - ✅✅A rounded "moonlike" appearance to the face
With excessive secretion of adrenocorticotropic hormone (ACTH) and chronic corticosteroid use, the
person with Cushing's syndrome develops a rounded moonlike face; prominent jowls; red cheeks; and
hirsutism on the upper lip, lower cheek, and chin. The remaining options are not associated with the
assessment findings in Cushing's syndrome.
, The nurse is developing a plan of care for a client with Cushing's syndrome. The nurse documents a
client problem of excess fluid volume. Which nursing actions should be included in the care plan for this
client? Select all that apply.
1.Monitor daily weight.
2.Monitor intake and output.
3.Assess extremities for edema.
4.Maintain a high-sodium diet.
5.Maintain a low-potassium diet. - ✅✅1.Monitor daily weight.
2.Monitor intake and output.
3.Assess extremities for edema.
The client with Cushing's syndrome and a problem of excess fluid volume should be on daily weights and
intake and output and have extremities assessed for edema. He or she should be maintained on a high-
potassium, low-sodium diet. Decreased sodium intake decreases renal retention of sodium and water.
The nurse is caring for a client who has had an adrenalectomy and is monitoring the client for signs of
adrenal insufficiency. Which signs and symptoms indicate adrenal insufficiency in this client?
1.Hypotension and fever
2.Mental status changes and hypertension
3.Subnormal temperature and hypotension
4.Complaints of weakness and hypertension - ✅✅1.Hypotension and fever
The nurse should be alert to signs and symptoms of adrenal insufficiency after adrenalectomy. These
signs and symptoms include weakness, hypotension, fever, and mental status changes. The remaining
options are incorrect.
The nurse is providing home care instructions to the client with a diagnosis of Cushing's syndrome and
prepares a list of instructions for the client. Which instructions should be included on the list? Select all
that apply.
answers
A client with a diagnosis of addisonian crisis is being admitted to the intensive care unit. Which findings
will the interprofessional health care team focus on? Select all that apply.
1. Hypotension
2. Leukocytosis
3. Hyperkalemia
4. Hypercalcemia
5. Hypernatremia - ✅✅Hypotension
Hyperkalemia
In Addison's disease, also known as adrenal insufficiency, destruction of the adrenal gland leads to
decreased production of adrenocortical hormones, including the glucocorticoid cortisol and the
mineralocorticoid aldosterone. Addisonian crisis, also known as acute adrenal insufficiency, occurs when
there is extreme physical or emotional stress and lack of sufficient adrenocortical hormones to manage
the stressor. Addisonian crisis is a life-threatening emergency. One of the roles of endogenous cortisol is
to enhance vascular tone and vascular response to the catecholamines epinephrine and norepinephrine.
Hypotension occurs when vascular tone is decreased and blood vessels cannot respond to epinephrine
and norepinephrine. The role of aldosterone in the body is to support the blood pressure by holding salt
and water and excreting potassium. When there is insufficient aldosterone, salt and water are lost and
potassium builds up; this leads to hypotension from decreased vascular volume, hyponatremia, and
hyperkalemia. The remaining options are not associated with addisonian crisis.
The nurse is reviewing the laboratory test results for a client with a diagnosis of Cushing's syndrome.
Which laboratory finding would the nurse expect to note in this client?
1.A platelet count of 200,000 mm3 (200 × 109/L)
2.A blood glucose level of 110 mg/dL (6.28 mmol/L)
3.A potassium (K+) level of 5.5 mEq/L (5.5 mmol/L)
4.A white blood cell (WBC) count of 6000 mm3 (6 × 109/L) - ✅✅A potassium (K+) level of 5.5 mEq/L
(5.5 mmol/L)
,The client with Cushing's syndrome experiences hyperkalemia, hyperglycemia, an elevated WBC count,
and elevated plasma cortisol and adrenocorticotropic hormone levels. These abnormalities are caused
by the effects of excess glucocorticoids and mineralocorticoids in the body. The laboratory values listed
in the remaining options would not be noted in the client with Cushing's syndrome.
The nurse is caring for a client with a diagnosis of Addison's disease and is monitoring the client for signs
of Addisonian crisis. The nurse should assess the client for which manifestation that would be associated
with this crisis?
1.Agitation
2.Diaphoresis
3.Restlessness
4.Severe abdominal pain - ✅✅Severe abdominal pain
Addisonian crisis is a serious life-threatening response to acute adrenal insufficiency that most
commonly is precipitated by a major stressor. The client in addisonian crisis may demonstrate any of the
signs and symptoms of Addison's disease, but the primary problems are sudden profound weakness;
severe abdominal, back, and leg pain; hyperpyrexia followed by hypothermia; peripheral vascular
collapse; coma; and renal failure. The remaining options do not identify clinical manifestations
associated with addisonian crisis.
The nurse is performing an assessment on a client with a diagnosis of Cushing's syndrome. Which should
the nurse expect to note on assessment of the client?
1.Skin atrophy
2.The presence of sunken eyes
3.Drooping on 1 side of the face
4.A rounded "moonlike" appearance to the face - ✅✅A rounded "moonlike" appearance to the face
With excessive secretion of adrenocorticotropic hormone (ACTH) and chronic corticosteroid use, the
person with Cushing's syndrome develops a rounded moonlike face; prominent jowls; red cheeks; and
hirsutism on the upper lip, lower cheek, and chin. The remaining options are not associated with the
assessment findings in Cushing's syndrome.
, The nurse is developing a plan of care for a client with Cushing's syndrome. The nurse documents a
client problem of excess fluid volume. Which nursing actions should be included in the care plan for this
client? Select all that apply.
1.Monitor daily weight.
2.Monitor intake and output.
3.Assess extremities for edema.
4.Maintain a high-sodium diet.
5.Maintain a low-potassium diet. - ✅✅1.Monitor daily weight.
2.Monitor intake and output.
3.Assess extremities for edema.
The client with Cushing's syndrome and a problem of excess fluid volume should be on daily weights and
intake and output and have extremities assessed for edema. He or she should be maintained on a high-
potassium, low-sodium diet. Decreased sodium intake decreases renal retention of sodium and water.
The nurse is caring for a client who has had an adrenalectomy and is monitoring the client for signs of
adrenal insufficiency. Which signs and symptoms indicate adrenal insufficiency in this client?
1.Hypotension and fever
2.Mental status changes and hypertension
3.Subnormal temperature and hypotension
4.Complaints of weakness and hypertension - ✅✅1.Hypotension and fever
The nurse should be alert to signs and symptoms of adrenal insufficiency after adrenalectomy. These
signs and symptoms include weakness, hypotension, fever, and mental status changes. The remaining
options are incorrect.
The nurse is providing home care instructions to the client with a diagnosis of Cushing's syndrome and
prepares a list of instructions for the client. Which instructions should be included on the list? Select all
that apply.
